Additional Service Requirements for Opioid Maintenance

(A) Drug Screening. The Licensed or Approved Provider shall provide for the following: An initial drug-screening completed for each prospective patient as required by 105 CMR 164.305(D)(2). (2) Results of drug screening are to be used as a clinical tool and not as the sole factor in the diagnosis and treatment of the patient and for monitoring the patient's drug-use patterns before and during treatment. The Licensed or Approved Provider's Medical Director shall ensure drug screen results are not used to force a patient out of treatment, but are used as an aid in making treatment decisions. (3) Drug screening may be done by one of the following: blood, oral swab, urine testing, or other method as defined by the Department. (B) Pregnant Women. (1) The Licensed or Approved Provider shall ensure each pregnant woman is fully informed concerning the possible benefits and risks of opioid treatment to herself and to the fetus. The Licensed or Approved Provider shall document provision of this information in the patient's record. (2) The Licensed or Approved Provider shall establish a QSOA for prenatal, obstetrical and gynecological services, unless licensee provides these services directly. (C) Medically Supervised Withdrawal Rate. The rate of medically supervised withdrawal shall be determined by a practitioner employed or contracted by the Licensed or Approved Provider, to be appropriate to the patient's medical and psychiatric conditions and the dosage level at which the patient was being medicated before the decision was made to terminate. In determining the appropriate course of dosage reduction, the medical director shall review the patient's record, and consider the patient's physical and mental health status, and with consent of the patient, may take into account the opinions of the patient's other practitioners and medical providers.